Haemorrhoids

Symptoms of Haemorrhoids (Piles) include bleeding from back passage, itching, feeling of lump hanging out of anus, which may need to be pushed back in. Haemorrhoids can be painful if they become thrombosed.

Investigations:

All rectal bleeding is not due to Haemorrhoids and this needs to be confirmed with investigations which include:

  • Clinical examination of the back passage.
  • Rigid sigmoidoscopy/ proctoscopy (examination of back passage with a tube).This can be done at the time of initial consultation.
  • Flexible sigmoidoscopy -examination of the colon with a fibreoptic scope.

Treatment:

  • Haemorrhoids can be treated with dietary modification alone(increase fibre and fluid intake) or may require intervention such as Banding or Surgery.
  • Banding can be performed in the outpatient clinic. A tight elastic band is applied to the base of haemorrhoid which cuts of the blood flow to the piles and they eventually fall off in a week or so.
  • Surgery can be Haemorrhoidectomy or THD/HALO
  • Haemorrhoidectomy involves excising the haemorrhoids under general anaesthetic . This is very successful treatment for haemorrhoids and is usually performed as a day case.
  • THD/HALO- This procedure involves using an ultrasound device to identify the arteries supplying the haemorrhoids. These are then tied using stitches cutting blood flow to the piles. This is relatively less painful procedure compared to haemorrhoidectomy and is performed under general anaesthetic as a day case.